2024
Area Vulnerability and Disparities in Therapy for Patients With Metastatic Renal Cell Carcinoma
Rahman S, Long J, Westvold S, Leapman M, Spees L, Hurwitz M, McManus H, Gross C, Wheeler S, Dinan M. Area Vulnerability and Disparities in Therapy for Patients With Metastatic Renal Cell Carcinoma. JAMA Network Open 2024, 7: e248747. PMID: 38687479, PMCID: PMC11061765, DOI: 10.1001/jamanetworkopen.2024.8747.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaArea-level measuresRenal cell carcinomaPatient-level factorsSystemic therapyEthnic disparitiesRelative risk ratiosSocially vulnerable areasCell carcinomaMeasures of social vulnerabilityMedicare beneficiariesCohort studyFee-for-service Medicare Parts AOdds ratioReceipt of systemic therapyLogistic regressionArea-level characteristicsAssociated with lack of treatmentNon-Hispanic blacksRetrospective cohort studyIndividual-level demographicsNon-Hispanic whitesAssociated with disparitiesUS Medicare beneficiariesMeasures of disadvantage
2023
Total and treatment-related costs of care associated with in patients with metastatic renal cell carcinoma receiving targeted or immune therapy.
Rahman S, Long J, Westvold S, Wheeler S, Spees L, Leapman M, Hurwitz M, McManus H, Gross C, Dinan M. Total and treatment-related costs of care associated with in patients with metastatic renal cell carcinoma receiving targeted or immune therapy. JCO Oncology Practice 2023, 19: 28-28. DOI: 10.1200/op.2023.19.11_suppl.28.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaOral anticancer agentsInitial treatmentRetrospective cohort studyUse of immunotherapyYear of diagnosisRenal cell carcinomaDirect treatment costsMean Medicare paymentsMedicare paymentsMedicare Part DInitial therapyCohort studyMetastatic diagnosisCell carcinomaCombination therapyImmunotherapyMedicare beneficiariesPatientsAge 65Disease controlOlder ageStudy periodTherapyDiagnosisDisparities in immune and targeted therapy utilization for older US patients with metastatic renal cell carcinoma
Chow R, Long J, Hassan S, Wheeler S, Spees L, Leapman M, Hurwitz M, McManus H, Gross C, Dinan M. Disparities in immune and targeted therapy utilization for older US patients with metastatic renal cell carcinoma. JNCI Cancer Spectrum 2023, 7: pkad036. PMID: 37202354, PMCID: PMC10276895, DOI: 10.1093/jncics/pkad036.Peer-Reviewed Original ResearchConceptsOral anticancer agentsTherapy utilizationMedicare beneficiariesNon-Hispanic white raceMetastatic renal cell carcinomaNon-Hispanic black raceOlder US patientsUS Medicare beneficiariesRenal cell carcinomaLogistic regression modelsTherapy receiptMultivariable adjustmentSystemic therapyMale sexUS patientsCell carcinomaStudy criteriaBlack raceFemale sexPatient raceWhite raceImmunotherapyOutcomes persistSexPatientsEvolution of systemic therapy from 2015 to 2019 for older patients in the United States with metastatic renal cell carcinoma.
Chow R, Long J, Hassan S, Wheeler S, Spees L, Leapman M, Hurwitz M, McManus H, Gross C, Dinan M. Evolution of systemic therapy from 2015 to 2019 for older patients in the United States with metastatic renal cell carcinoma. Journal Of Clinical Oncology 2023, 41: 610-610. DOI: 10.1200/jco.2023.41.6_suppl.610.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaImmune checkpoint inhibitorsOral anti-cancer agentsNon-Hispanic white patientsSystemic therapyRenal cell carcinomaNHW patientsWhite patientsCell carcinomaMedicare beneficiariesService Medicare Parts ARetrospective cohort studyOverall treatment rateMedicare Part AIO therapyMRCC therapyAnti-cancer agentsCheckpoint inhibitorsCohort studyOlder patientsRandomized trialsSurvival improvementFirst therapyStudy criteriaTreatment receipt
2022
Racial and Ethnic Variation in COVID-19 Vaccination Uptake Among Medicare Beneficiaries with Cancer History
Poghosyan H, Dinan MA, Tamamyan G, Nelson L, Jeon S. Racial and Ethnic Variation in COVID-19 Vaccination Uptake Among Medicare Beneficiaries with Cancer History. Journal Of Racial And Ethnic Health Disparities 2022, 10: 2354-2362. PMID: 36149576, PMCID: PMC9510246, DOI: 10.1007/s40615-022-01415-2.Peer-Reviewed Original ResearchConceptsNon-Hispanic white beneficiariesCancer historyVaccine doseMedicare beneficiariesWhite beneficiariesVaccine uptakeHispanic beneficiariesMultivariable logistic regression analysisCOVID-19 vaccination uptakeSelf-reported cancer historyCOVID-19 vaccine uptakeSelf-reported receiptCOVID-19 vaccination ratesLogistic regression analysisNon-Hispanic blacksSelf-reported raceUnvaccinated beneficiariesVaccination uptakeVaccine dosesVaccination ratesVaccine confidenceVaccine availabilitySupplement surveyCross-sectional dataEthnic variationOral Anticancer Agent (OAA) Adherence and Survival in Elderly Patients With Metastatic Renal Cell Carcinoma (mRCC)
Dinan MA, Wilson LE, Greiner MA, Spees LP, Pritchard JE, Zhang T, Kaye D, George D, Scales CD, Baggett CD, Gross CP, Leapman MS, Wheeler SB. Oral Anticancer Agent (OAA) Adherence and Survival in Elderly Patients With Metastatic Renal Cell Carcinoma (mRCC). Urology 2022, 168: 129-136. PMID: 35878815, PMCID: PMC9588695, DOI: 10.1016/j.urology.2022.07.012.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaOral anticancer agentsRenal cell carcinomaCell carcinomaMedicare beneficiariesPocket costsOdds of adherenceRetrospective cohort studyDisease-specific survivalReal-world adherenceRCC-specific survivalProportion of daysNon-significant trendAdherent useOAA therapyCohort studyElderly patientsMultivariable analysisStudy criteriaUnivariate analysisOAA treatmentPatientsCarcinomaAdherenceSurvival
2020
Rapid rise in the cost of targeted cancer therapies for Medicare patients with solid tumors from 2006 to 2015
Wilson LE, Greiner MA, Altomare I, Rotter J, Dinan MA. Rapid rise in the cost of targeted cancer therapies for Medicare patients with solid tumors from 2006 to 2015. Journal Of Geriatric Oncology 2020, 12: 375-380. PMID: 33250425, DOI: 10.1016/j.jgo.2020.11.007.Peer-Reviewed Original ResearchConceptsProstate cancerCancer costsLung cancerBreast cancerProportion of patientsSystemic anticancer therapyPart D enrollmentNew malignanciesPatients 65Systemic therapyMedicare 5Colorectal cancerInvasive lungMedicare patientsCohort analysisMedicare populationMedicare beneficiariesPatientsSolid tumorsTherapyCancerAnticancer therapyCancer therapyFinancial burdenLung
2019
Simulated Costs of the ASCO Patient-Centered Oncology Payment Model in Medicare Beneficiaries With Newly Diagnosed Advanced Ovarian Cancer.
Moss HA, Havrilesky LJ, Wang FF, Georgieva MV, Hendrix LH, Dinan MA. Simulated Costs of the ASCO Patient-Centered Oncology Payment Model in Medicare Beneficiaries With Newly Diagnosed Advanced Ovarian Cancer. JCO Oncology Practice 2019, 15: e1018-e1027. PMID: 31613721, PMCID: PMC10445789, DOI: 10.1200/jop.19.00026.Peer-Reviewed Original ResearchConceptsAdvanced ovarian cancerOvarian cancerAlternative payment modelsNeoadjuvant chemotherapy patientsEmergency department visitsSEER-Medicare dataMean total costOutpatient emergency department visitsPayment modelsHealth care servicesCost-efficient careAvoidable spendingNeoadjuvant chemotherapyReal-world practiceDepartment visitsChemotherapy patientsCancer careMedicare beneficiariesHospitalizationCare servicesPatientsService MedicareChemotherapySurgeryPotential cost savingsChemotherapy Costs and 21-Gene Recurrence Score Genomic Testing Among Medicare Beneficiaries With Early-Stage Breast Cancer, 2005 to 2011.
Dinan MA, Wilson LE, Reed SD. Chemotherapy Costs and 21-Gene Recurrence Score Genomic Testing Among Medicare Beneficiaries With Early-Stage Breast Cancer, 2005 to 2011. Journal Of The National Comprehensive Cancer Network 2019, 17: 245-254. PMID: 30865923, DOI: 10.6004/jnccn.2018.7097.Peer-Reviewed Original ResearchConceptsLow-risk diseaseHigh-risk patientsHigh-risk diseaseRS testingMedicare beneficiariesPrimary analysisEstrogen receptor-positive breast cancerReceptor-positive breast cancerLower chemotherapy useIntermediate-risk diseaseIntermediate-risk patientsRetrospective cohort studyGenomic testingSEER-Medicare dataChemotherapy useCohort studyMultivariable analysisBreast cancerChemotherapy costsLow overall useMAIN OUTCOMEMedicare populationPatientsHigher overall costsDisease
2018
PHS152 The Impact of Functional Status and Multi-Morbidity On Surveillance Use Among Medicare Beneficiaries with Bladder Cancer
Georgieva M, Lund J, Nielsen M, Trogdon J, Dinan M, Weinberger M, Wheeler S. PHS152 The Impact of Functional Status and Multi-Morbidity On Surveillance Use Among Medicare Beneficiaries with Bladder Cancer. Value In Health 2018, 21: s141. DOI: 10.1016/j.jval.2018.04.951.Peer-Reviewed Original ResearchAssociation between physician characteristics and the use of 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2008–2011
Wilson LE, Pollack CE, Greiner MA, Dinan MA. Association between physician characteristics and the use of 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2008–2011. Breast Cancer Research And Treatment 2018, 170: 361-371. PMID: 29536319, DOI: 10.1007/s10549-018-4746-6.Peer-Reviewed Original ResearchConceptsMedical oncologistsPhysician characteristicsBreast cancerGenomic testingMedicare beneficiariesAmerican Medical Association Physician Master FileNode-negative breast cancerEarly-stage breast cancerReceipt of testingMethodsRetrospective cohort studyYear of diagnosisPhysician-level factorsPhysician-level characteristicsMultivariable regression modelsAdjuvant chemotherapyCohort studyRS testingOptimal careResultsA totalStudy criteriaSurgical oncologySurgical proceduresHigher oddsMAIN OUTCOMELower odds
2015
Association Between Use of the 21-Gene Recurrence Score Assay and Receipt of Chemotherapy Among Medicare Beneficiaries With Early-Stage Breast Cancer, 2005-2009
Dinan MA, Mi X, Reed SD, Lyman GH, Curtis LH. Association Between Use of the 21-Gene Recurrence Score Assay and Receipt of Chemotherapy Among Medicare Beneficiaries With Early-Stage Breast Cancer, 2005-2009. JAMA Oncology 2015, 1: 1098. PMID: 26313372, DOI: 10.1001/jamaoncol.2015.2722.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAntineoplastic AgentsBiomarkers, TumorBreast NeoplasmsChemotherapy, AdjuvantChi-Square DistributionFemaleGene Expression ProfilingGenetic Predisposition to DiseaseGenetic TestingGuideline AdherenceHumansInsurance BenefitsMedicareMultivariate AnalysisNeoplasm Recurrence, LocalNeoplasm StagingOdds RatioPatient SelectionPhenotypePractice Guidelines as TopicPredictive Value of TestsRetrospective StudiesRisk AssessmentRisk FactorsSEER ProgramTime FactorsTreatment OutcomeUnited StatesConceptsReceipt of chemotherapyLower chemotherapy useHigh-risk diseasePatients 70 yearsChemotherapy useBreast cancerRecurrence scoreMedicare beneficiariesNational Comprehensive Cancer Network guidelinesEarly-stage breast cancerConsideration of chemotherapyLow-risk diseaseOverall chemotherapy useIncident breast cancerLow-risk patientsRetrospective cohort studyHigh-risk patientsPrespecified subgroup analysisUse of chemotherapyAdditional prognostic informationEnd Results (SEER) dataInvasive breast cancerRS assayNCCN riskAdjuvant chemotherapy
2014
Redistribution of Health Care Costs after the Adoption of Positron Emission Tomography among Medicare Beneficiaries with Non–Small-Cell Lung Cancer, 1998–2005
Dinan MA, Curtis LH, Carpenter WR, Biddle AK, Abernethy AP, Patz EF, Schulman KA, Weinberger M. Redistribution of Health Care Costs after the Adoption of Positron Emission Tomography among Medicare Beneficiaries with Non–Small-Cell Lung Cancer, 1998–2005. Journal Of Thoracic Oncology 2014, 9: 512-518. PMID: 24736074, DOI: 10.1097/jto.0000000000000102.Peer-Reviewed Original ResearchConceptsCell lung cancerTotal health care costsHealth care costsPositron emission tomographyProportion of patientsRate of surgeryMedicare beneficiariesLung cancerCare costsEmission tomographySurgical resectionInpatient costsRetrospective cohort studyYear of diagnosisMain outcome measuresCohort studyTreatment patternsOutcome measuresRadiation therapyChemotherapyPatientsRadiotherapyStudy periodCancerMedicare approval
2013
Variations in Use of PET among Medicare Beneficiaries with Non–Small Cell Lung Cancer, 1998–2007
Dinan MA, Curtis LH, Carpenter WR, Biddle AK, Abernethy AP, Patz EF, Schulman KA, Weinberger M. Variations in Use of PET among Medicare Beneficiaries with Non–Small Cell Lung Cancer, 1998–2007. Radiology 2013, 267: 807-817. PMID: 23418003, DOI: 10.1148/radiol.12120174.Peer-Reviewed Original ResearchConceptsNon-small cell lung cancerPositron emission tomographyUse of PETMedicare beneficiariesCases of NSCLCPET useDiagnosis of NSCLCEnd Results-Medicare dataMultivariable logistic regression analysisDuke University Health SystemHalf of patientsCell lung cancerExamination 2 monthsMultivariable regression analysisUniversity Health SystemLogistic regression analysisDemographic subgroupsRegression analysisInstitutional review boardNonblack patientsPrimary outcomeFinal cohortSurveillance EpidemiologyLung cancerRetrospective analysis
2012
Stage Migration, Selection Bias, and Survival Associated With the Adoption of Positron Emission Tomography Among Medicare Beneficiaries With Non–Small-Cell Lung Cancer, 1998-2003
Dinan MA, Curtis LH, Carpenter WR, Biddle AK, Abernethy AP, Patz EF, Schulman KA, Weinberger M. Stage Migration, Selection Bias, and Survival Associated With the Adoption of Positron Emission Tomography Among Medicare Beneficiaries With Non–Small-Cell Lung Cancer, 1998-2003. Journal Of Clinical Oncology 2012, 30: 2725-2730. PMID: 22753917, DOI: 10.1200/jco.2011.40.4392.Peer-Reviewed Original ResearchConceptsPositron emission tomographyOverall survivalStage migrationMedicare beneficiariesAdvanced diseasePET useEnd Results-Medicare dataEmission tomographyProportion of patientsStage IV diseaseCell lung cancerSelection biasUpstaging of diseaseGreater overall survivalStage-specific survivalStudy criteriaLung cancerSurvival AssociatedImproved outcomesRetrospective analysisStage distributionNSCLCPatientsDiseaseSurvival
2011
Financial implications of changes in the initial treatment of prostate cancer among Medicare beneficiaries.
Dinan M, Robinson T, Zagar T, Scales C, Curtis L, Reed S, Schulman K, Lee W. Financial implications of changes in the initial treatment of prostate cancer among Medicare beneficiaries. Journal Of Clinical Oncology 2011, 29: 6115-6115. DOI: 10.1200/jco.2011.29.15_suppl.6115.Peer-Reviewed Original Research
2010
Changes in the Use and Costs of Diagnostic Imaging Among Medicare Beneficiaries With Cancer, 1999-2006
Dinan MA, Curtis LH, Hammill BG, Patz EF, Abernethy AP, Shea AM, Schulman KA. Changes in the Use and Costs of Diagnostic Imaging Among Medicare Beneficiaries With Cancer, 1999-2006. JAMA 2010, 303: 1625-1631. PMID: 20424253, DOI: 10.1001/jama.2010.460.Peer-Reviewed Original ResearchConceptsNon-Hodgkin lymphomaLung cancerMedicare beneficiariesBreast cancerCancer typesColorectal cancerProstate cancerImaging costsPositron emission tomography scanIncident breast cancerYear of diagnosisEmission tomography scanBone density studiesMean total costMagnetic resonance imagingPositron emission tomographyBone scanTreatment patternsIncident casesCancer careHalf of beneficiariesTomography scanUS CentersMean annual increaseResonance imaging